Age, Neurological Status MRC Scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy

Abstract

INTRODUCTIONTemozolomide and concomitant radiotherapy followed by temozolomide has been used as a standard therapy for the treatment of newly diagnosed glioblastoma multiform since 2005. A search for prognostic factors was conducted in patients with glioblastoma routinely treated by this strategy in our institution.METHODSThis retrospective study included all patients with histologically proven glioblastoma diagnosed between June 1, 2005, and January 1, 2012, in the Franche-Comté region and treated by radiotherapy (daily fractions of 2 Gy for a total of 60 Gy) combined with temozolomide at a dose of 75 mg/m2 per day, followed by six cycles of maintenance temozolomide (150–200 mg/m2, five consecutive days per month). The primary aim was to identify prognostic factors associated with overall survival (OS) in this cohort of patients.RESULTSOne hundred three patients were included in this study. The median age was 64 years. The median OS was 13.7 months (95% confidence interval, 12.5–15.9 months). In multivariate analysis, age over 65 years (hazard ratio [HR] = 1.88; P = 0.01), Medical Research Council (MRC) scale 3–4 (HR = 1.62; P = 0.038), and occurrence of postoperative complications (HR = 2.15; P = 0.028) were associated with unfavorable OS.CONCLUSIONSThis study identified three prognostic factors in patients with glioblastoma eligible to the standard chemotherapy and radiotherapy treatment. Age over 65 years, MRC scale 3–4, and occurrence of postoperative complications were associated with unfavorable OS. A simple clinical evaluation including these three factors enables to estimate the patient prognosis. MRC neurological scale could be a useful, quick, and simple measure to assess neurological status in glioblastoma patients.

A Survival Score Based on Symptoms and Performance Status for Patients with High-grade Gliomas Receiving Radiochemotherapy

“…These findings agree well with those of previous studies (20,(22)(23)(24)(25), thus demonstrating consistency with the results of the present study.…”

Survival rates in patients with the newly diagnosed glioblastoma: Data from the National Cancer Registry of Ukraine, 2008-2016

“…The available data of recent studies suggest the overall median survival rates as 12.5-15.9 months with HR for age over 65 years 1.88 [16]. Other declares median survival time and 2-year OS being 18.0 months and 38.9% after chemoradiotherapy compared to 12.7 months and 12.6% after radiotherapy [17].…”

The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients

“…Here, the Karnofsky Performance Score (KPS) is commonly used to assess the overall physical status as well as to monitor possible tumor progression via a decrease of clinical performance (9,10). Moreover, poor or worsened overall neurological performance (11)(12)(13)(14) and isolated motor or language deficits might be associated with decreased overall survival (15,16). In order to address this rising evidence and to standardize the evaluation of neurological performance, the Neurologic Assessment in Neuro-Oncology (NANO) scale was created (17).…”